Fatal lead encephalopathy following foreign body ingestion: Case report

A 23-month-old female child presented to an emergency department with a mild, nonspecific gastrointestinal illness and periodic fussiness and irritability; the initial physical examination was nonfocal and nondiagnostic. Rapid decompensation quickly ensued. Postmortem examination of hematologic laboratory data and reevaluation of radiographs showed a metallic foreign body in the stomach. Diagnosis of rapidly fatal lead encephalopathy was confirmed by finding toxic serum lead and elevated delta-aminolevulinic (ALA) levels in postmortem blood.